Provider Demographics
NPI:1477431864
Name:MACHARIA, SAMUEL KINYANJUI
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:KINYANJUI
Last Name:MACHARIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 DARBY LN
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6741
Mailing Address - Country:US
Mailing Address - Phone:301-281-5445
Mailing Address - Fax:
Practice Address - Street 1:405 DARBY LN
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6741
Practice Address - Country:US
Practice Address - Phone:301-281-5445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212601163WC0400X, 163WC1500X, 163WH0200X, 163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health